“How old was your maternal grandmother when she died?” It seems a simple question, one we ask our patients every time we construct a pedigree. Many people know the answer to within a few years, an accuracy that is perfectly fine for genetic counseling purposes. However, for a significant minority this seems to be a particularly challenging query, and they look at me as if I had asked them to use differential calculus to predict the orbital position of Ganymede on April 12, 2019.
Over the last few months I have informally collected responses to the Grandma’s Age Question. Here are some of the responses:
1) She died in 2006. Do the math.
2) Do you mean Maw-Maw or Baba?
3) Oh, that was the year we moved to North Carolina.
4) Well, she died when my mother was 35. How old would that have made her?
5) She died a long time after my grandfather died.
6) She was born in 1898, and she died on her wedding anniversary.
7) Do you mean my biological grandmother or my grandfather’s second wife who raised my mother?
8) I never really liked her very much.
9) She died of a heart attack. What is the average age of people dying from a heart attack?
10) She died of the diabetes when she was 83. No wait, that was my Aunt Hannah, who married into the family but she was like a grandmother to me. Grandma J died of the pleurisy at 90. Or was that Nona? Nona was my Italian grandmother. She was a good cook but she didn’t like my father very much. Oh, I don’t know. One of my grandmothers died at 62 and the other one died when she was 90-something. I think. One of them had Congenital Heart Failure I know.
11) She was old.
12) She was young.
13) Her sister lived to be 104 but Grandma didn’t live as long as her sister.
14) She died a few years ago when she was 88. I mean, no, wait, she’s still alive.
15) I know I put 73 on that form you sent me in the mail but I just made up an age because I felt like I had to put down some number. I really don’t know how old she was.
16) She was pretty old, oh, maybe….(thinks for a few moments)… 63. Huh, that’s my age now. But she looked so old to me!
17) She was so vain that she always lied about her age. She even destroyed her birth certificate so no one would ever know her true age.
18) Patient: She was 85. Husband, head turning towards patient: No, she was 86. Patient, head turning towards spouse: No, she died a month after we got married. She came to our wedding and told everybody she was 85. Husband, eyes rolling: No, she announced she was 86 at the wedding. You were too drunk to remember. Patient, head straight, eyes closed: Don’t roll your eyes at me. She was my grandmother, not your’s. And I know for a fact she was 85. Husband, looking out the window and exhaling: 86. Patient, looking directly at me: 85. He’s wrong. Husband, looking directly at me: Her grandmother was 86. She’s wrong. Silence.
So what counseling sense can I make of these responses? Well, like everything else about genetic counseling, there is no simple underlying pattern. Sometimes, the response is an opening to discuss complicated family dynamics or it provides a context that helps me better understand patients’ psychological dimensions. In other situations, divorces and strained family relations account for lack of familiarity with a relative. For some, the inability to recall the information stems from having recently been diagnosed with cancer or having a child identified with a serious syndrome,
and their minds are focused on bigger issues than recalling obscure family facts.
Then there are organic explanations, like Chemo Brain and Pregnancy Raging Hormone Brain. And this can be a particularly challenging question for older patients, who have failing memory skills and whose grandparents may have died a half century ago.
Perhaps too grandma’s age is a bit of information that is less important to some people, knowledge lost with the disappearance of The Family Bible and the geographic dispersal of families in modern times.
I am interested to hear other counselors’ experiences and thoughts about the Grandma’s Age Question.